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more successful patient treatment.
The proposed patient authorization model allows
for a greater participation, responsibility and control
over information security and contents of patient’s
EHR. This model is innovative as it allows the
patient to define access control permissions within
his PHN but also outside this network when
necessary, providing a better healthcare treatment at
the point of care. The functional roles subject of care
agent direct and indirect can also be beneficial
because they can allow patients’ relatives to also
take part and help in their treatment. Furthermore,
these can help treating patients’ relatives when, for
example, they can have access to relevant genetic
information about their parents or other relatives.
Even if this information is not directly accessible,
those functional roles could have the BTG
permission to access it and the owner of the EHR
would always be notified of the actions performed
within his/her EHR. The flexibility of access and
definition of access by the patient is not meant to
invade or compromise healthcare professionals’
workflows or privacy as there will be a restricted
area (EHR component) only to be used and accessed
by that healthcare professional. The temporal
constraint with the separation of duties integrated
within the authorization model allows to define the
level of patients’ privacy as fine-grained as the
patient desires. To access a patient’s EHR the user
should belong to the patient’s PHN, however a user
can also access the patient’s EHR if there are any
delegated permissions (user delegation) defined for
him or in emergency situations activating the
mechanism BTG.
However, in order to use this model, the patient has
to understand and use information technologies (IT)
and have basic IT skills to define and use a platform
that will integrate this new model. Problems with
this model include the fact that users may mistrust
what they are accessing as well as not being able to
access all they think should be available to them.
Also, the patient may not be capable of defining
proper access control rules and unwantedly hide
healthcare information that can be crucial to perform
effective treatments. However, this can also happen
no matter what type of record or access is made to
the EHR. The patient can always omit relevant
information for his/her treatment.
5 CONCLUSIONS
This paper constitutes the starting point to define a
RBAC based patient authorization model that can be
used in real practice. With this model we hope to
bridge the gap that exists between legislation (with
medical data protection definition) and what really
happens in practice. With the growth of new
technologies and the interest that patients have to be
in control and take an active part in their treatment,
the authors feel that the patients need to have a
simple but focused model that allows them to easily
define access permissions but also closely
collaborate and interact with their healthcare
professionals.
Future work includes the implementation and
evaluation of the proposed authorization model with
a specific case study in real healthcare practice.
ACKNOWLEDGEMENTS
This work is funded by FEDER funds (Programa
Operacional Factores de Competitividade –
COMPETE) and by National funds (FCT –
Fundação para a Ciência e a Tecnologia) through
project OFELIA – Open Federated Environments
Leveraging Identity and Authorization [PTDC/EIA-
EIA/104328/2008].
REFERENCES
American Health Information Management Association
Foundation. 2011. myPHR [Online]. American Health
Information Management Association. Available:
http://www.myphr.com/ [Accessed October 2011].
Beimel, D. Peleg, M. 2009. The Context and the SitBAC
Models for Privacy Preservation – An Experimental
Comparison of Model Comprehension and Synthesis.
IEEE Transactions on Knowledge and Data
Engineering
Council of Europe 1997. Protection of Medical Data -
Recommendation nºR (97) 5. In: committee of
ministers to member states (ed.). Europe.
Ferreira, A., Chadwick, D., Zao, G., Farinha, P., Correia,
R., Chilro, R. ,Antunes, L. 2009. How securely break
into RBAC: the BTG-RBAC model. Proceedings from
25th Annual Computer Security Applications
Conference - ACSAC 2009.
Ferreira, A., Correia, A., Silva, A., Corte, A., Pinto, A.,
Saavedra, A., Pereira, A. L., Pereira, A. F., Cruz-
Correia, R., Antunes, L. F. 2007a. Why Facilitate
Patient Access to Medical Records. Medical and Care
Compunetics 4, 127, 77-90.
Ferreira, A., Cruz-Correia, R., Antunes, L. ,Chadwick, D.
2007b. Access Control: how can it improve patients'
healthcare? . Stud Health Technol Inform, 127, 65-76.
Giuri, L. 1996. Role-based access control: a natural
approach. Proceedings of the first ACM Workshop on
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